title: Incidence of stroke and socioeconomic neighborhood characteristics: an ecological analysis of Dijon stroke registry.
abstract: OBJECTIVE
  Studies have shown higher stroke incidence in areas with higher levels of deprivation. We aimed to determine the pattern of association between various area socioeconomic status (SES) indicators and stroke incidence in specific sex and age groups.
  
  
  METHODS
  Data are from the Dijon stroke registry for the period 1995 to 2003. The analyses included 1255 cases aged older than 40 (median age, 76.8). Poisson regression was used to model stroke incidence according to the SES level of 61 small areas.
  
  
  RESULTS
  Among women, stroke incidence was higher in neighborhoods with large income inequality (incidence rate ratio, 1.34; P=0.003), higher proportions of unemployed (1.24; P=0.02), of non-French nationals (1.21, P=0.02), and of rented housing (1.31; P=0.03). Areas with a higher proportion of people aged older than 60 were associated with lower stroke incidence (incidence rate ratio, 0.72; P=0.01). Analysis by specific age-groups showed stronger effects among the 60- to 74-year-olds. Among men, no associations between SES and stroke incidence were identified overall but analysis by age groups showed significant effect among the 40- to 59-year-olds. In this age group, incidence rate ratios were 1.47 for unemployment (P=0.01), 1.86 for no car ownership (P=0.02), and 1.56 for income inequality (P=0.01). Among stroke cases, no trend in vascular risk factors prevalence according to area SES was identified.
  
  
  CONCLUSIONS
  Variations of stroke incidence were more marked for the SES indicators of wealth and of income inequality. They were apparent at an earlier age in men and showed a stronger gradient among women.
authors.affiliation: French School of Public Health, Rennes, France. olivier.grimaud@ehesp.fr
authors.forename: Olivier
authors.initials: O
authors.lastname: Grimaud
authors.forename: Yannick
authors.initials: Y
authors.lastname: Béjot
authors.forename: Zoe
authors.initials: Z
authors.lastname: Heritage
authors.forename: Julie
authors.initials: J
authors.lastname: Vallée
authors.forename: Jerôme
authors.initials: J
authors.lastname: Durier
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Cadot
authors.forename: Maurice
authors.initials: M
authors.lastname: Giroud
authors.forename: Pierre
authors.initials: P
authors.lastname: Chauvin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007182:Income; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D012042:Registries; D012111:Residence Characteristics / Q000145:classification*; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D020521:Stroke / Q000453:epidemiology*